This blog maintains the thoughts on various topics related to biomedical and health informatics by Dr. William Hersh, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University.

Saturday, February 13, 2010

Informatics is a Field of Global Truths

As all of my friends on Facebook know, I recently spent an enjoyable two weeks in Asia, with stops in Hong Kong, Singapore, and Bangkok. Certainly one of the things I enjoy most about my work is getting to interact with colleagues in the field from all over the world.

One thing I have definitely learned in my countless interactions with friends, colleagues, and others in Europe, South America, Asia, Africa, and elsewhere is that the principles of informatics apply no matter where you are on the planet. There are indeed global truths in the informatics field, just as there are in medicine, i.e., while different diseases occur with different frequencies and somewhat different manifestations around the globe, the same basic pathologies that afflict the human organism do so no matter where the human is located. Whether it is infectious diseases or chronic diseases, relatively similar approaches to diagnosing and treating disease apply universally.

I believe that the same notion applies in informatics. That is, the factors that motivate and govern informatics in the United States do the same elsewhere, i.e., the use of information to improve human health, healthcare, public health, and biomedical research. This does not mean that some of the issues manifest themselves in diverse ways in different settings. But principles like the need to understand the clinical setting and its workflows as well as to provide value to the full spectrum of "users" from clinicians and citizens to institutional leaders and ministries of health apply universally.

I have also come to learn in this journey that there is a global need to build human capacity in informatics. Indeed, I had the opportunity to share thoughts and a framework for developing it in a paper published in the current issue of the journal Health Affairs, which is devoted to eHealth in the developing world. My co-authors include Dr. Alvaro Margolis from Uruguay and Drs. Fernan Quiros and Paula Otero from Argentina. Other papers in the issue focus on other issues and challenges in this area, such as standards and interoperability, use of mobile health (mHealth) technologies, and policy development. As most people who work in this area know, there has been an explosion in the growth of mobile phone technology and its use to truly benefit these developing economies. A press release from the American Medical Informatics Association also summarizes the papers.

On February 16th, I will be in Washington, DC participating in a press event about the papers in this issue of Health Affairs. I intend to make the above points in the few minutes that I have to talk.

The notion of global truths in informatics was clearly visible on my recent trip. My first stop was in Hong Kong to lead a two-day seminar on health informatics for allied health professionals in the Hong Kong Hospital Authority. The Hospital Authority is undertaking an impressive comprehensive national program to develop a universal electronic health record (EHR) for all public hospitals. This system will also facilitate health information exchange (HIE) from private hospitals. One of the main reasons for the project's success to date has been the leadership of Dr. NT Cheung, who has paid meticulous attention to both the needs of all stakeholders of the system as well as the most appropriate technologies to be implemented. He has also assembled a well-trained team (some of whom I have also trained in the 10x10 course!). We (including those of us in the United States) can learn plenty about the right way to do informatics in this effort.

My next stop was Singapore, where I have been running an offering of the 10x10 course with my colleague Dr. KC Lun of Gateway Consulting. Although the course has attracted a regional audience, a large number of participants have come from the Singapore Ministry of Health Holdings and local healthcare institutions. There are many robust informatics projects being undertaken in Singapore, including a national EHR with HIE from various hospitals.

My final stop on the trip was Bangkok, Thailand, a country with a rich tradition of a strong healthcare system. One event in Bangkok was the opportunity to give a talk about informatics to the Dean and the clinical department chairs of the Ramathibodi Hospital Faculty of Medicine of Mahidol University. Being a department chair in a medical school myself, I had a natural kinship with this group, and enjoyed in engaging them in a well-informed conversation.

I also attended in Bangkok the Prince Mahidol Award Conference, which is an annual conference devoted to global health issues. The theme of this year's conference was Global Health Information Systems and how they can improve individual health, better inform health leaders, and improve the delivery of healthcare and public health. I gave a presentation on a panel devoted to the human resources capacity required to achieve optimal use of such information systems. The conference also adopted a Call to Action that, among other things, called for investments in building capacity.

I look forward to my continued work with colleagues around the world to build the capacity that allows informatics to play its role in improving health, healthcare, public health, and biomedical research.